Postgraduate Thesis: A systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least one year

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TitleA systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least one year
AuthorsLau, Ka-yee.
劉嘉儀.
Issue Date2011
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
AbstractBackground: Type I immediate implant placement has gained popularity because it may reduce treatment time, number of surgeries and post-extraction bone loss. However, this is potentially challenged by inadequate keratinized mucosa for flap adaptation and difficulties in achieving primary stability. Moreover, it has been proven that post-extraction bone loss is an inevitable biological process, which affects treatment outcomes. Objectives: To estimate survival and success rates of implants and the implantsupported prostheses, the prevalence of biological, technical and aesthetic complications, and the magnitude of soft and hard tissue changes following implant placement immediately into fresh extraction sockets. Material & methods: An electronic search in MEDLINE (PubMed) and the Cochrane library from 1991 to July 2010 was performed to include prospective studies on immediate implants with a mean follow-up time of at least 1 year. The survival rates were computed using the STATA statistical software. Weighted means of soft and hard tissue changes were obtained by the inverse variance method. Results: A total of 46 prospective studies, with a mean follow-up time of 2.08 years, were included. The annual failure rate of immediate implants was 0.82% (95% CI: 0.48%-1.39%), translating into the 2-year survival rate of 98.4% (97.3%-99.0%). Among the 5 factors analyzed [reasons for extraction, antibiotic use, position of implant (anterior versus posterior, maxilla versus mandible), type of loading], only the regimen of antibiotic use affected the survival rate significantly. Lower failure rates were found in groups that were provided with a course of post-operative antibiotics. The success of implant therapy was difficult to assess due to scarce reporting on biological, technical and aesthetic complications. Soft tissue changes occurred mostly in the first 3 months after the provision of restoration, and then stabilized towards end of the first year. Marginal bone loss predominantly took place in the first year after implant placement, with a magnitude generally less than 1mm. Controversy on hard tissue preservation with platform-switching technique remained unsolved. Conclusions: Despite the high survival rate observed, more long-term studies are necessary to determine the success of implant treatment provided immediately after tooth extraction. Special attention has to be given to aesthetic outcomes.
DegreeMaster of Dental Surgery
SubjectDental implants.
Dept/ProgramDental Surgery
DOIhttp://dx.doi.org/10.5353/th_b4696056
DC Field
Value
dc.contributor.authorLau, Ka-yee.
dc.contributor.author劉嘉儀.
dc.date.hkucongregation2011
dc.date.issued2011
dc.description.abstractBackground: Type I immediate implant placement has gained popularity because it may reduce treatment time, number of surgeries and post-extraction bone loss. However, this is potentially challenged by inadequate keratinized mucosa for flap adaptation and difficulties in achieving primary stability. Moreover, it has been proven that post-extraction bone loss is an inevitable biological process, which affects treatment outcomes. Objectives: To estimate survival and success rates of implants and the implantsupported prostheses, the prevalence of biological, technical and aesthetic complications, and the magnitude of soft and hard tissue changes following implant placement immediately into fresh extraction sockets. Material & methods: An electronic search in MEDLINE (PubMed) and the Cochrane library from 1991 to July 2010 was performed to include prospective studies on immediate implants with a mean follow-up time of at least 1 year. The survival rates were computed using the STATA statistical software. Weighted means of soft and hard tissue changes were obtained by the inverse variance method. Results: A total of 46 prospective studies, with a mean follow-up time of 2.08 years, were included. The annual failure rate of immediate implants was 0.82% (95% CI: 0.48%-1.39%), translating into the 2-year survival rate of 98.4% (97.3%-99.0%). Among the 5 factors analyzed [reasons for extraction, antibiotic use, position of implant (anterior versus posterior, maxilla versus mandible), type of loading], only the regimen of antibiotic use affected the survival rate significantly. Lower failure rates were found in groups that were provided with a course of post-operative antibiotics. The success of implant therapy was difficult to assess due to scarce reporting on biological, technical and aesthetic complications. Soft tissue changes occurred mostly in the first 3 months after the provision of restoration, and then stabilized towards end of the first year. Marginal bone loss predominantly took place in the first year after implant placement, with a magnitude generally less than 1mm. Controversy on hard tissue preservation with platform-switching technique remained unsolved. Conclusions: Despite the high survival rate observed, more long-term studies are necessary to determine the success of implant treatment provided immediately after tooth extraction. Special attention has to be given to aesthetic outcomes.
dc.description.naturepublished_or_final_version
dc.description.thesisdisciplineDental Surgery
dc.description.thesislevelmaster's
dc.description.thesisnameMaster of Dental Surgery
dc.identifier.doihttp://dx.doi.org/10.5353/th_b4696056
dc.identifier.hkulb4696056
dc.languageeng
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)
dc.relation.ispartofHKU Theses Online (HKUTO)
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
dc.source.urihttp://hub.hku.hk/bib/B46960569
dc.subject.lcshDental implants.
dc.titleA systematic review on survival and success rates of implants placed immediately into fresh extraction sockets after at least one year
dc.typePG_Thesis